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204 Cards in this Set

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Name 3 types of non-narcotics.
acetaminophen,aspirin,nonsteroidal anti-inflamm drugs
Give 3 properties of nsaids including aspirin.
-analgesic
-anti-inflammatory
-anti-pyretic
How do non-narcotics work?
Block cyclooxygenase which is needed to synthesize prostaglandins which cause inflammation.
Which cox protects the stomach-lining, decreases temperature, and promotes platelet aggregation.
cox 1
Which cox triggers pain and inflammation?
cox 2
Give some examples of cox 1 inhibitors.
ibuprofen,aspirin,naproxen
What are the 4 side effects of cox 1 inhibitors?
gastric irritation, ulcers, gi bleeding, decreased blood clotting
What are two examples of cox 2 inhibitors?
celebrex and mobic
How do cox 2 inhibitors differ from cox 1 inhibitors?
less gi disturbance, no effect on blood clotting, and increased effectiveness related to pain and inflammation
What is enteric coated and caffeine aspirins?
ecotrin and anacin
What should you not give to children under 12 and why?
aspirin- reye's syndrome
What does aspirin do to platelet aggregation?
decreases clotting
How should nsaids be taken?
with food to prevent gi upset
What occurs if you have a nsaid overdose?
salicylate od-tinnitus (ringing in ears), dizziness, bronchospasm,and itchiness
What is trade name of acetaminophen?
tylenol
How does acetaminophen work?
Inhibits prostaglandin synthesis...not on cox inhibitors
Is acetaminophen able to be taken by all ages?
yes- no link to reye's
How is acetaminophen different than nsaids and aspirin?
no gastric issues, no effect on clotting, no anti-inflammatory properties though
What is the mass daily dose of tylenol (acetaminophen) a day? what about liver patients?
4 grams a day and 2000 mg w/ liver patients
How do narcotic analgesics work?
They suppress pain impulses and has cns effects.
Give 3 types of opioid derivatives.
codeine,synthetic codeine, morphine
What are the side effects 7 of narcotic analgesics?
respiratory suppression,anti-tussive effects, nausea, vomiting,decreased bp,orthostatic hypotension,urinary retention
What is the antidote for narcotics?
naxolone (narcan)
What should be avoided when taking narcotics?
alcohols,sedatives,hypnotics....anything that could cause cns depression...and patients with head injuries
When would you use morphine? (3)
mi,cancer pain,dyspnea
What are the 5 routes of administration for morphine?
po,iv,im,sr,pca pump
What kind of conditions should you not use morphine with?
asthma,increase intercranial pressure and shock
What is hydromorphone (dilaudid)?
synthetic morphine that is 5-10 x more potent than morphine
What is meperidine (demerol)?
synthetic narcotic
How does demerol differ from morphine?
shorter duration of action and no anti-tussive properties
What are the 3 routes of administration for demerol?
im,iv,po
What was demerol used for?
post-op pain..changing
What are the 5 se of morphine?
respiratory depression, orthostat hypotension, drowsiness,constipation,and urinary retention
Is codeine more potent than morphine or demerol?
no
Can codeine be used with head injuries?
yes
What kind of property does codeine have?
anti-tussive
How is codeine combined?
frequently with synthetic drugs and combo with acetaminophen,aspirin,ibuprofen
What is fentanyl (duragesic)?
transdermal opioid analgesic
What does fentanyl provide?
continuous pain control for chronic or cancer pain
WHAT ARE COLD, ACUTE RHINITIS, SINUSITIS, AND ACUTE PHARYNGITIS?
URI
WHAT PART OF THE TRACT DOES THE COMMON COLD AFFECT?
NASOPHARYNGEAL
WHAT IS ACUTE INFLAMMATION OF THE MUCOUS MEMBRANES OF THE NOSE?
ACTUE RHINITIS
WHEN IS A COLD MOST CONTAGIOUS?
1-4 DAYS BEFORE ONSET OF SYMPTOMS WHICH IS THE INCUBATION PERIOD AND DURING FIRST 3 DAYS OF THE COLD
HOW DOES COLD TRANSMISSION MOSTLY OCCUR?
TOUCHING CONTAMINATED THINGS THEN TOUCHING THE NOSE OR THE MOUTH
WHAT ARE THE FOUR GROUPS OF DRUGS USED TO TREAT THE COMMON COLD?
ANTIHISTAMINES,DECONGESTANTS,ANTITUSSIVES,AND EXPECTORANTS
WHAT ARE H1 BLOCKERS OR H1 ANTAGONISTS?
ANTIHISTAMINES
HOW DO ANTIHISTAMINES WORK?
THEY COMPETE WITH HISTAMINE FOR RECEPTOR SITES THUS PREVENTING A HISTAMINE RESPONSE.
WHICH H RECEPTOR WHEN STIMULATED, CONSTRICTS EXTRAVASCULAR SMOOTH MUSCLE INCLUDING THE NASAL CAVITY?
H1
WHICH H RECEPTOR WHEN STIMULATED, INCREASES GASTRIC SECRETIONS?
H2
ARE ANTIHISTAMINES USEFUL IN ER SITUATIONS SUCH AS ANAPHPHYLAXIS?
NO
HOW FAST ARE ANTIHISTAMINES ABSORBED?
15 MINUTES
WHICH GENERATION OF A-HISTAMINES CAUSES DROWSINESS,DRY MOUTH, AND OTHER ANTICHOLINERGIC EFFECTS?
FIRST GENERATION
WHICH GENERATION OF A-HISTAMINES HAVE FEWER ANTICHOLINGERGIC EFFECTS AND A LOWER INCIDENCE OF DROWSINESS?
SECOND GENERATION
WHAT FIRST GENERATION ANTIHISTAMINE IS FREQUENTLY COMBINED WITH OTHER INGREDIENTS IN COLD REMEDIES TO TREAT RHINITIS?
DIPHENHYRAMINE
WHAT ARE CETIRIZINE(ZYRTEC) FEXOFENADINE(ALLEGRA) AND LORATADINE (CLARITIN) ARE WHAT KIND OF DRUGS?
2ND GENERATION ANTIHISTAMINES
HOW DO NASAL DECONGESTANTS WORK?
THEY STIMULATE THE ALPHA-ADRENERGIC RECEPTORS, PRODUCING VASCULAR CONSTRICTION OF THE CAPILLARIES.
WHAT CAN FREQUENT USE OF NASAL DECONGESTANTS, ESPECIALLY IN SPRAY OR DROPS RESULT IN?
TOLERANCE AND REBOUND NASAL CONGESTION DUE TO IRRITATION OF THE NASAL MUCOSA
WHAT ARE SYSTEMIC DECONGESTANTS (ALPHA-ADRENERGIC AGONISTS) USED FOR?
ALLERGIC RHINITIS,HAY FEVER,ACUTE CORYZA(PROFUSE NASAL DISCHARGE)
WHAT ARE EPHEDRINE, PHENYLEPHRINE(NEO-SYNEPHRINE), AND PSUEDOEPHEDRINE (SUDAFED)?
SYSTEMIC DECONGESTANTS
WHAT DRUG WHICH WAS A SYSTEMIC DECONGESTANT WAS TAKEN OFF THE SHELF DUE TO REPORTS OF STROKE, HIGH BP, RENAL FAILURE, AND DYSRHYTHMIAS?
PHENYLPROPANOLAMINE
WHAT IS THE ADVANTAGE OF SYSTEMIC DECONGESTANTS AND THE DOWNSIDE COMPARED TO NASAL DECONGESTANTS?
THEY RELIEVE NASAL CONGESTION FOR A LONGER PERIOD THAN NASAL DECONGESTANTS, BUT THEY ALSO ACT SLOWER AND CAUSE FEWER SEFFECTS.
WHAT ARE THE SA OF DECONGESTANTS?
NERVOUS,JITTERY,RESTLESS,INCREASED BP, INCREASED GLUCOSE
USAGE OF NASAL DECONGESTANTS LONGER THAN 5 DAYS COULD RESULT IN WHAT?
REBOUND NASAL CONGESTION
WHAT KIND OF PPL SHOULD USE CAUTION WHEN USING ALPHA-ADRENERGICS (DECONGESTANTS)?
people with hypertension, heart disease, hyperthyroidism, and diabetes mellitus
HOW DOES CAFFIENE EFFECT DECONGESTANTS?
INCREASE RESTLESSNESS AND PALPITATIONS
HOW DOES PSUEDOEPHEDRINE AFFECT BETA BLOCKERS?
DECREASES THEIR EFFECTS
TAKING DECONGESTANTS WITH MONOAMINE OXIDASE COULD LEAD TO WHAT?
THEY MAY INCREASE THE POSSIBILITY OF HYPERTENSION OR CARDIAC DYSRHYTHMIAS
WHAT ARE INTRANASAL GLUCOCORTICOIDS USED FOR?
TREATING ALLERGIC RHINITIS
HOW DO GLUCOCORTICOIDS WORK?
THEY HAVE AN ANTIINFLAMMATORY ACTION...
NAME SIX EXAMPLES OF INTRANASAL STERIODS.
1. BECLOMETHASONE
2.BUDESONIDE
3.DEXAMETHASONE
4.FLUNISOLIDE
5.FLUTICASONE
6.TRIAMCINOLONE
CAN GCORTICOIDS BE USED WITH H1 ANTIHISTAMNIES?
YES
HOW LONG SHOULD YOU USE INTRANASAL DEXAMETHASONE?
30 DAYS OR LESS
DO STEROIDS CAUSE SYSTEMIC EFFECTS?
RARELY
HOW DO ANTITUSSIVES ACT?
THEY ACT ON THE COUGH-CONTROL CENTER IN THE MEDULLA TO SUPPRESS THE COUGH REFLEX.
WHAT KIND OF COUGH CAN YOU HAVE AND TAKE ANTI-TUSSIVES?
NONPRODUCTIVE AND IRRITATING
WHAT ARE THE 3 TYPES OF ANTITUSSIVES?
NARCOTIC,NON-NARCOTIC AND COMBO PREPARATIONS
WHAT IS THE FUNCTION OF EXPECTORANTS?
THEY LOOSEN BRONCHIAL SECRETIONS SO THEY CAN BE COUGHED UP.
WHAT IS THE BEST EXPECTORANT/
HYDRATION
WHAT IS INFLAMMATION OF THE MUCOUS MEMBRANES OF ONE OR MORE OF THE MAXILLARY,FRONTAL,ETHMOID,OR SPHENOID SINUES?
SINUSITIS
WHAT IS HELPFUL FOR SINUSITIS?
ACETAMINOPHEN,DECONGESTANT,FLUIDS,REST...ANTIBIOTICS IF ACUTE OR SEVERE
WHAT IS INFLAMMATION OF THE THROAT?
ACUTE PHARYNGITIS
WHAT ARE THE 3 CAUSES OF ACUTE PHARYNGITIS?
VIRUS,BACTERIA,OR BETA-HEMOLYTIC STREPTOCOCCI
WHAT ARE SYMPTOMS OF ACUTE PHARYNGITIS?
ELEVATED TEMP AND COUGH
A THROAT CULTURE RETURNS POSITIVE FOR BETA-HEMOLYTICS STREPTOCOCCI..WHAT SHOULD BE DONE?
10 day antibiotic course prescribed..saline gargle,lozenges,increased fluid intake...acetaminophen for fever
WHAT IS COPD AND RESTRICTIVE PULMONARY DISEASE?
CHRONIC OBSTRUCTIVE PULMONARY DISEASE ...LOWER RESP TRACT DISORDERS
WHAT CAUSES COPD?
INCREASED AIRWAY RESISTANCE OF AIRFLOW TO THE LUNG TISSUES
WHAT ARE THE 4 MAJOR PULMONARY DISORDERS THAT CAUSE COPD?
CHRONIC BRONCHITIS,BRONCHIECTASIS,EMPHYSEMA,ASTHMA
HOW CAN ASTHMA CAUSE PERMANENT LUNG DAMAGE?
IF ATTACKS ARE FREQUENT AND BECOMES CHRONIC
COPD PATIENTS HAVE A DECREASE IN WHAT DISCOVERED BY TESTING?
FORCED EXPIRATORY VOLUME IN 1 SECOND
WHAT IS A DISEASE IN WHICH A DEREASE IN TOTAL LUNG CAPACITY AS A RESULT OF FLUID ACCUMULATION OR LOSS OF ELASTICITY OF THE LUNG?
RESTRICTIVE LUNG DISEASE
PULMONARY EDEMA,FIBROSIS,PHUEMONITIS,TUMORS,SCOLIOSIS, AND DISORDERS AFFECTING THE THORACIC MUSCULAR WALL ALL CAUSE WHAT?
RESTRICTIVE LUNG DISEASE
Name 7 drugs that treat copd.
1.bronchodilators
2.methylxanthines
3.leukotriene antagonists
4.glucocorticoids
5.cromolyn
6.anticholinergics
7.mucolytics
What is an inflammatory disorder that involves hyperresponsiveness of the airways with varying amount of airway obstruction?
astma
What 3 things trigger asthma
stress,allergens and pollutants
Which asthma is characterized by bronchospasm, wheezing, mucus, and dyspnea?
bronchial asthma
IN WHAT DISEASES IS LUNG DAMAGE PERMANENT?
CHRONIC BRONCHITIS, EMPHYSEMA, BRONCHIECTASIS
IS THERE WHEEZING IN BRONCHITIS,EMPHYSEMA,AND BRONCHIECTASIS?
NO
WHAT IS A PROGRESSIVE LUNG DISEASE CAUSED BY SMOKING OR CHRONIC LUNG INFECTIONS?
CHRONIC BRONCHITIS
INFLAMMATION AND MUCUS DO WHAT IN CHRONIC BRONCHITIS?
AIRWAY OBSTRUCTION
WHAT CAN BE HEARD ON AUSCULATATION IN CHRONIC BRONCHITIS?
INSP AND EXP RHONCHI
WHAT TWO THINGS LEAD TO RESPIRATORY ACIDOSIS IN CHRONIC BRONCHITIS?
HYPERCAPNIA AND HYPOXEMIA
WHAT DISEASE HAS AN ABNORMAL DILATION OF BRONCHI AND BRONCHIOLES SECONDARY TO FREQUENT INFECTION AND INFLAMMATION?
BRONCHIECTASIS
WHAT HAPPENS TO THE BRONCHIOLES DURING BRONCHIECTASIS?
THEY BECOME OBSTRUCTED BY THE BREAKDOWN OF THE EPTHELIUM OF THE BRONCHIAL MUCOSA...TISSUE FIBROSIS MY RESULT
WHAT ARE THE 3 CAUSES OF EMPHYSEMA?
CIGARETTES,ATMOSPHERIC CONTAMINANTS, OR LACK OF ALPHA-ANTITRYPSIN PROTEIN
HOW DOES THE ALPHA-ANTITRYPSIN PROTEIN WORK?
WORKS ON PROTEOLYTIC ENZYMES RELEASED BY BACTERIA OR PHAGOCYTIC CELLS
What happens to the bronchioles during emphysema?
The terminal ones become plugged with mucus, causing a loss in the fiber and elastin network in the alveoli. The alveoli enlarge as walls are destroyed and air gets trapped in the overstretched albeoli leading to inadequate gas exchange.
Name 7 types of drugs prescribed for copd.
bronchodilators,glucocortoids,leukotriene modifiers,expectorants, and antibiotics,cromolyn and nedocromil
What is the function of glucocortcoids?
decrease inflammation
What is the function of leukotriene modifiers?
reduce inflammation of lung
What are the functions of cromolyn and nedrocromil
antiflammatory agents by suppressing the release of histamine and other mediators from mast cells
What is periods of bronchospasm resulting in wheezing and difficulty in breathing?
bronchial asthma
What increases cAMP, causing dilation of the bronchioles?
sympathomimetics: alpha- and beta2 adrengergic agonists
What drug could be given during acute bronchospasm r/t allergic anaphylaxis to promote bronchodilation and elevate bp?
sympathomimetic epinephrine (ADRENALIN0
WHAT IS ADMINISTERED IN IN EMERGENCY SITUATIONS TO RESTORE CIRCULATION AND INCREASE AIRWAY PATENCY?
EPIHINEPHRINE
FOR BRONCHOSPASMS R/T CHRONIC ASTHMA OR COPD, WHAT IS GIVEN?
BETA-ADRENERGIC AGONISTS BECAUSE THEY ACT PRIMARILY ON BETA 2 RECEPTORS, THEREFORE SIDE EFFECTS ARE LESS SEVERE THAN THOSE OF EPINEPHRINE WHICH ACTS ON ALPHA,BETA,AND BETA2 RECEPTORS
WHAT ARE THE NEWER BETA-ADRENERGIC DRUGS FOR ASTHMA MORE SELECTIVE FOR?
BETA 2 RECEPTORS
WHAT DO HIGH DOSE OR OVERUSE OF BETA2 ADRENERGIC AGENTS FOR ASTHMA CAUSE?
BETA 1 RESPONSE SUCH AS NERVOUSNESS, TREMOR, AND INCREASED PULSE
WHAT IS AN IDEAL BETA2 AGONIST AND WHY IS IT IDEAL?
ALBUTEROL- SELECTIVE FOR BETA2 AND CAUSES BRONCHODILATION WITH A LONGER DURATION OF ACTION.
WHAT IS METAPROTERNOL?
BETA-ADRENERGIC AGENT USED PRIMARILY ON BETA2 BUT CAN HAS SOME BETA1
WHAT IS ADMINISTERED FOR LONG TERM ASTHMA?
BETA2-ADRENERGIC AGONISTS BY INHALATION
WHAT IS GOOD ABOUT INHALATION ROUTE ADMINISTRATION?
GOOD BECAUSE DELIVERS MORE DRUG DIRECTLY TO THE CONSTRICTED SITE, LESS TO ADMINISTER THAN IF GIVEN PO, AND FEWER SIDE EFFECTS- FASTER
WHAT WAS THE FIRST BETA-ADRENERGIC AGENT USED FOR BRONCHOSPASM?
ISOPROTERENOL
WHAT DOES ISOPROTERENOL STIMULATE AND HOW LONG IS IT'S ACTION?
BETA 1 AND 2 RECEPTORS-SHORT
WHAT OCCURS IF BETA 1 RECEPTORS ARE STIMULATED?
HEART RATE INCREASES AND TACHYCARDIA EXISTS
WHAT OCCURS IF BETA 2 RECEPTORS ARE STIMULATED?
PROMOTES BRONCHODILATION
HOW IS ISOPROTERENOL ADMINISTERED?
INHALE,NEBULIZE,IV FOR SEVERE ATTACKS
WHY IS ISOPROTERENOL SELDOMLY PRESCRIBED?
SEVERE SIDE EFECTS FROM BETA 1 RESPONSES
WHY WOULD ONE USE A SPACER?
TO IMPROVE DRUG DELIVERY TO THE LUNG WITH LESS DEPOSITION IN THE MOUTH
WHAT CAN EXCESSIVE USE OF AEROSOL DRUG LEAD TO?
TOLERANCE AND LOSS OF EFFECTIVENESS,PARADOXICAL AIRWAY RESISTANCE,TREMORS,NERVOUSNESS,INCREASED HEART RATE
WHAT ARE THE SIDE EFFECTS AND ADVERSE REACTIONS OF EPINEPHRINE? 7
1.DIZZNESS
2.TREMOR
3.PALPITATIONS
4.TACHYCARDIA
5.DYSRHYTHMIA
6.ANGINA
7.HYPERTENSION
WHAT ARE THE SIDE EFFECTS ASSOCIATED WITH BETA 2-ADRENERGICS? 6
1. TREMOR
2.HEADACHE
3.NERVOUSNESS
4.INCREASED PULSE
5.PALPITATIONS
6.INCREASE BLOOD GLUCOSE LEVEL
IF TOLERANCE TO BETA2 ADRENERGICS OCCURS WHAT SHOULD BE DONE?
DOSE INCREASED MAYBE OR IF FAIL TO CORRECT MAY WORSEN THE ASTHMA AND REQUIRES NEW EVALUATION
WHAT IS IPRATROPIUM BROMIDE OR ATROVENT?
ANTICHOLINERGIC DRUG THAT TREATS ASTHMATIC CONDITIONS BY DILATION
WHAT ANTICHOLINERGIC HAS THE FEWEST SIDE EFFECTS?
IPRATROPIUM BROMIDE OR ATROVENT
IF SOMEONE USES ATROVENT AND A BETA-AGONIST INHALANT,HOW SHOULD THEY ADMINISTER THEIR MEDS?
THEY SHOULD ADMINISTER THE BETA-AGONIST INHALANT 5 MINS BEFORE USING ATROVENT
HOW SHOULD SOMEONE ADMINISTER THEIR MEDS IF ON ANTICHOLINERGIC AGENT WITH AN INHALED GLUCOCORTICOID OR COMROLYN?
THE ANTICHOLINERGIC AGENT SHOULD BE ADMINISTERED 1ST 5 MINS BEFORE THE CROMOLYN OR GLUCOCORTICOID BECAUSE THIS WILL CAUSE BRONCHIOLES TO DILATE AND THE STEROID OR CROMOLYN CAN BE DEPOSITED IN THE BRONCHIOLES
WHAT COMBO-DRUGS ARE USED TO TREAT CHRONIC BRONCHITIS?
IPRATROPIUM BROMIDE-ATROVENT AND ALBUTEROL SULFATE COMBIVENT BECAUSE MORE EFFECTIVE TOGETHER AND INCREASE THE FEV
WHAT IS THE FEV?
paramater used to evaluate asthmatics and obstructive lung disease and response to bronchodilator therapy
What are methylxanthine derivatives?
bronchodilators used to treat asthma
What are 3 xanthines?
caffiene,aminophylline, and thophylline
What are xanthines function? 5
bronchodilate,stimulate cns, respiration,dilate coronary vessels,cause diuresis
Theophylline has what function?
relaxes smooth muscles of the bronchi,bronchioles, and pulmonary blood vessels by inhibiting the enzyme phosphodiesterase...increases camp
What is special about Theophylline's therapeutic index and range?
low ti and narrow tr
What can you give with theophylline?
sympathomimetic adrenergic agents
What is theophylline prescribed for?
maintenance therapy for chronic stable asthma and other copds
Who should you not give theophylline?
clients with renal, liver, or cardac diseases.
What are side effects of theophylline? 18
1.nausea
2.vomit
3.anorexia
4.gastric pain
5.intestinal bleed
6.nervousness
7.dizziness
8.headache
9.irritability
10.dystrhymia
11.tachycard
12.hypotensive
13.hyprreflexia
14.seizures
15.insomnia
16.hyperglycemia
17.decreased clot time
18.rarely low wbc

more severe in children
how can you decrease the potential for side effects when taking theophylline?
dont take other xanthinies with it
if thophylline-aminophylline is the derivative is given iv-how?
slowly via infusion pump iv
HOW DOES BETA BLOCKERS, TAGAMET,INDERAL,AND ERYTHROMYCIN AFFECT?
DECREASE LIVER RATE AND INCREASE THE HALF LIFE AND EFFECTS OF THEOPHYLIINE
WHAT TWO DRUGS DECREASE THE EFFECTS OF THEOPHYLLINE?
BARBITUATE AND CARBAMAZEPINE
WHAT IS A CHEMICAL MEDIATOR THAT CAN CAUSE INFLAMMATORY CHANGES IN THE LUNG?
LEUKOTRIENE
WHAT LEUKOTRIENES ARE AFFETIVE IN EOSINOPHIL MIGRATION, MUCUS, AND AIRWAY WALLA EDENA..BCONSTRICT?
CYSTEINYL LEUKOTRIENES
WHAT LEUKOTRIENES ARE EFFECTIVE IN REDUING THE INFLAMMATORY SYMPTOMS OF ASTHMA ?
LT RECEPTOR ANTAGONIST AND LT SYNTHESIS INHIBITORS..LEUKOTRIENE MODIFIERS
WHAT ARE LEUKOTRIENE MODIFIERS USED FOR?
EXERCISE-INDUCED ASTHMA-CHRONIC ASTHMA NOT ACUTE!
NAME 3 LEUKOTRIENE MODIFIERS.
ACCOLATE,ZYFLO,SINGULAIR
WHAT ARE FUNCTIONS OF ACCOLATE?
LT RECEPTOR ANTAGONIST....REDUCE BRONCHOCONSTRICTION
WHAT IS FUNCTION OF ZYFLO?
LT SYNTHESIS INHIBITOR....DECREASES BRONCHOCONSTRICTION....
ACCOLATE AND ZYFLO ARE GIVEN TO WHOM?
12 YEARS AND UP
WHO CAN HAVE SINGULAIR?
6 Y AND OLDER
WHAT IS FUNCTION OF SINGULAIR?
LT RECEPTOR ANTAGONIST
WHAT ARE GLUCOSTEROIDS USED FOR?
TREAT RESP DISORDERS ASTHMA
WHAT KIND OF ACTION DO GLUCOSTEROIDS HAVE?
ANTIINFLAMMATORY
WHEN ARE GLUCOSTEROIDS USED?
WHEN PT. IS UNRESPONSIVE TO BRONCHODILATOR THERAPY OR IF CLIENT HAS ATACK WHILE ON MAX DOSE OF THEOPHYLLINE OR AN ADRENERGIC DRUG
WHAT ARE 3 WAYS GLUCOSTEROIDS CNA BE GIVEN?
MDI,TABLET,IV
NAME 2 GLUCOCORTICOID INHALANTS
VANCERIL AND BELCOVENT
NAME 7 TABLETS OF GLUCOCORTICOIDS..
1.AMCORT
2.ARISTOCORT
3.AZMACORT
4.DECADRON
5.PREDNISONE
6.PRENISOLONE
7.METHYLPREDNISOLONE
WHAT ARE TWO IV GLUCOCORTICOIDS
1. HYDROCORTISONE
2. DEXAMETHASONE
WHY WOULD YOU NOT GIVE A GLUCOCORTICOID INHALANT WITH A SEVERE ASTHMA ATTACK?
WOULD TAKE 1-4 WEEKS FOR AN INHALED STEROID TO REACH FULL EFFECT....GIVE IV...AND WEAN TO ORAL OR INHALED
WHY SHOULD GLUCOCORTICOIDS BE GIVEN WITH FOOD?
THEY CAN IRRIATE GASTRIC MUCOSA.
WHY SHOULD GLUCOCORTICOIDS BE WEANED SLOWLY?
PREVENT ADRENAL INSUFFICIENCY
WHY IS IT MORE DANGEROUS TO GIVE PO GLUCOCORTICOIDS THAN WITH INHALANT?
ADRENAL SUPPRESSION
WHAT IS ADVAIR AND WHAT IS ITS FUNCTION?
GLUCOCORTICOD AND SALMETEROL..KEEPS ASTHMA IN CHECK...2X A DAY...NOT REPLACE FAST-ACT INHALER FOR SUDDEN SYMPTOMS...ALLEVIATES AIRWAY CONSTRICTION AND INFLAMMATION
WHAT ARE SE RELATED TO ORALLY INHALED GLUCOCORTICOIDS?
LOCAL-THROAT IRRIATION,HOARSENSS,DRY MOUTH,COUGHING,FUNGAL INFECTIONS
HOW CAN CANDIDA ALBICANS BE PREVENTED WITH INHALED GLUCOCORTICOIDS?
SPACER, RINSE AFTER DOSING, WASHING DAILY WITH WARM WATER
WHAT ARE SE OF LONG TERM ORAL OR IV GLUCOCORTICOIDS?
PUFFY EYELIDS,EDEMA IN LOWER EXTREMITIES,MOON FACE,WEIGHT GAIN,THIN SKIN,PURPURA,ABNORMAL FAT DISTRIBUTION,INCREASED BLOOD SUGAR,IMPAIRED IMMMUNE RESPONSE
WHAT IS INTAL -CROMOLYN SODIUM- USED FOR?
PROPHYLACTIC TX OF BRONCHIAL ASTHMA DAILY
IS INTAL USED DAILY?
YES, NOT FOR ACUTE ASTHMA ATTACKS...
HOW DOES CROMOLYN INTAL WORK?
STOPS RELEASE OF HISTAMINE, WHICH CAUSES ASTHMA ATTACK
WHAT ARE SE OF CROMOLYN INTAL?
BAD TASTE AND COUGH
HOW IS CROMOLYN ADMINISTERED?
INHALED
WHAT 2 CAN CROMOLYN BE ADMINISTERED WITH?
BETA ADRENERGICS AND XANTHINE DERIVATIVES
WHY SHOULD CROMOLYN NOT BE DISCONTINUED ABRUPTLY?
REBOUND ASTHMA ATTACK CAN OCCUR
WHAT IS FUNCTION OF NEDOCROMIL SODIUM?
ANTIINFLAMMATORY SUPPRESSES RELEASE OF HISTAMINE,LEUKOTRIENES,AND OTHERS FROM MAST CELLS..PREVENTS...NOT FOR ACUTE ASTHMA ATTACK
WHAT IS MORE EFFECTIVE CROMOLYN OR NEDOCROMIL?
NEDOCROMIL
WHAT DRUGS USED FOR ASTHMATIC CHILDREN? 4
CROMOLYN OR NEDROCROMIL
GLUCOSTEROID OR ORAL BETA2-ADRENERGIC AGONIST
WHAT DRUGS NOT USED FOR ASTHMATIC ELDERS? 3
BETA2-ADRENERGIC AGONIST, METHYLXANTHINES,GLUCOSTEROIDS...CAUSE SIDE EFFECTS
WHAT IS FUNCTION OF MUCOLYTICS?
LIQUEFY AND LOOSEN THICK MUCOUS SECRETIONS SO THEY CAN BE EXPECTORATED
HOW IS MUCOMYST ADMINISTERED?
NEBULIZER
SHOULD MUCOLYTICS BE MIXED?
NO BUT CAN BE ADMINISTERED ALONGSIDE
HOW SHOULD BRONCHODILATORS AND MUCOLYTICS BE ADMINISTERED TOGETHER?
BRONCHODILATOR 5 MIN BEFORE
WHAT ARE 4 SIDE EFFECTS OF MUCOLYTICS?
NAUSEA,VOMIT,ORAL ULCERS,RUNNY NOSE
WHAT CAN MUCOMYST BE USED AS OTHER THAN A MUCOLYTIC/
ACETAMINOPHEN ANTIDOTE IF GIVEN WITHIN 12-24 HOURS OF OVERDOSE
WHAT DOES PULMOZYNE DO?
MUCOLYTIC THAT DIGESTS DNA IN THICK SPUTUM SECRETIONS OF CLIENTS WITH CYSTIC FIBROSIS, REDUCES INFECTION, IMPROVES PULMONARY FUNCTION
WHAT ARE THE 4 SIDE EFFECTS OF PULMOZYME?
CHEST PAIN,SORE THROAT,LARYNGITIS,AND HOARSENESS
What three effects are there for nsaids?
antiinflammatory, antipyretic and analgesic
What is aspirin?
aspirin is a salicylate and nsaid
What are the two functions of aspirin?
fever reducer and analgesic and decreases platelet aggregation
Who should not take aspirin?
children under 12-reye syndrome
Why would mds prescribe 81-162-325 mg once a day and one 325 mg tablet every other day of aspirin?
prevent transiet ischemic attacks, mi, or any clot epidsode
How does aspirin and nsaids relieve pain?
They inhibit the enzyme cyclooxygenase,which is needed to make prostaglandins
Which cox protects stomach lining and regulates blood clots?
cox 1
Which cox triggers pain and inflammation at the injured site?
cox 2
What two groups of analgesics inhibit or block cox 1 and cox 2?
salicylates and nsaids